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PubMed1983

Cutaneous malignant histiocytosis: a clinical and histopathologic study of eight cases, with immunohistochemical analysis.

Eight cases of autopsy-proved malignant histiocytosis (MH) are reported, in which cutaneous involvement was a prominent finding at initial clinical presentation. In two patients, the disease remained confined to the skin for significant periods before systemic dissemination appeared. Immunohistochemical analysis of cutaneous infiltrates of MH showed uniform negativity of the atypical cells for lysozyme, immunoglobulin light chain, glycogen, and chloroacetate esterase content. In five cases, cytochemical stains for acid phosphatase, butyrate (nonspecific) esterase, chloroacetate esterase, and peroxidase activity were performed on bone marrow aspirates containing malignant cells; all demonstrated diffuse positivity for acid phosphatase and nonspecific esterase, and negativity for peroxidase and chloroacetate esterase. Touch-imprint preparations of cutaneous lesions in one of these cases yielded identical results. These findings indicate that cytochemical methods are preferable to immunohistochemical technics in identification of histiocytic malignancies and that foci of skin involvement may provide a useful source for such diagnostic evaluation.

Acid Phosphatase↗
PubMed2001

Roles of tumour localization, second signals and cross priming in cytotoxic T-cell induction.

The vertebrate immune system has evolved to protect against infections that threaten survival before reproduction. Clinically manifest tumours mostly arise after the reproductive years and somatic mutations allow even otherwise antigenic tumours to evade the attention of the immune system. Moreover, the lack of immunological co-stimulatory molecules on solid tumours could result in T-cell tolerance; that is, the failure of T cells to respond. However, this may not generally apply. Here we report several important findings regarding the immune response to tumours, on the basis of studies of several tumour types. First, tumour-specific induction of protective cytotoxic T cells (CTLs) depends on sufficient tumour cells reaching secondary lymphatic organs early and for a long enough duration. Second, diffusely invading systemic tumours delete CTLs. Third, tumours that stay strictly outside secondary lymphatic organs, or that are within these organs but separated from T cells by barriers, are ignored by T cells but do not delete them. Fourth, co-stimulatory molecules on tumour cells do not influence CTL priming but enhance primed CTL responses in peripheral solid tumours. Last, cross priming of CTLs by tumour antigens, mediated by major histocompatibility complex (MHC) class I molecules of antigen-presenting host cells, is inefficient and not protective. These rules of T-cell induction and maintenance not only change previous views but also rationales for anti-tumour immunotherapy.

Animals↗
PubMed1988

Ki-1 positive large cell lymphoma. A morphologic and immunologic study of 19 cases.

In this report, we analyze the clinical, morphologic, and immunologic findings of 19 patients with Ki-1+ large cell lymphoma, a recently described malignant lymphoma which is usually of T-cell phenotype. Most patients in this selected series of 14 children and adolescents and five adults presented with peripheral lymphadenopathy or skin lesions. No patient had bone marrow involvement. Distinctive morphologic features of Ki-1+ large cell lymphoma are tumor cell pleomorphism, sinus infiltration, fibrosis, partial lymph node involvement, sparing of B-cell regions, and a prominent plasma cell infiltrate. Seventy-two percent of cases were of T-cell phenotype; the remaining cases expressed neither B- nor T-cell-specific markers. Virtually all cases were positive for Ia (HLA-DR), Tac (interleukin-2 receptor), and T9 (transferrin receptor), indicating that this lymphoma is frequently a tumor of activated T-cells. We conclude that a diagnosis of Ki-1+ large cell lymphoma should be considered in any pleomorphic tumor with the features described in this report.

Adolescent↗
PubMed1975

The staging of renal parenchymal tumours.

The relation between the anatomical features in the development of renal parenchymal tumours and the prognosis are analysed. It is suggested that the clinical and anatomical classification must be revised.

Humans↗
PubMed2005

Merkel cell carcinoma arising from the subcutaneous fat of the arm with intact skin.

BACKGROUND: Merkel cell carcinoma is a rare malignant neuroendocrine neoplasm characteristically arising from the dermis of sunlight-exposed skin. It rarely arises outside the skin. OBJECTIVE: We present a patient with primary Merkel cell carcinoma arising from subcutaneous fat, with no involvement of the overlying skin. We describe the clinical manifestations and magnetic resonance imaging (MRI) findings. METHODS: We report a 63-year-old woman with a primary lesion of Merkel cell carcinoma that arose from the subcutaneous fat layer of the left arm. The lesion presented as a subcutaneous nodule with intact overlying skin. MRI showed that the nodular lesion was located entirely in the subcutaneous fat layer, with no involvement of the dermis. Peritumoral infiltration around the lesion and enlarged lymph nodes deep to the lesion were noted. The patient received wide excision of the lesion with dissection of the regional lymph nodes and adjuvant radiotherapy and chemotherapy. RESULTS: Histopathologic examination confirmed the diagnosis of Merkel cell carcinoma with local lymphatic metastasis, and the lesion was completely located in the subcutaneous fat, with no involvement of the dermis. These findings were well correlated with MRI findings. CONCLUSION: Primary Merkel cell carcinoma may arise from the subcutaneous fat and present as an entirely subcutaneous lesion with intact skin. MRI is helpful to evaluate the local extension of the lesion and regional lymphatic metastasis.

Arm↗
PubMed1997

Multicellular origin of tenascin in skin tumors--an in situ hybridization study.

Tenascin mRNA expression was studied by an in situ hybridization method in 27 skin tumors. Tenascin synthesis was increased in all skin tumors when compared to uninvolved skin but there was variation in the site of cellular synthesis between different types of tumors. In melanocytic nevi and precancerous keratinocyte lesions, tenascin seemed to be of epidermal or stromal origin. In basal cell carcinoma, squamous cell carcinoma and malignant melanoma, there was tenascin synthesis also in tumor cells. These findings are in concordance with earlier studies which suggest a role of tenascin as an anti-adhesive and motility-promoting factor in malignant skin tumors.

Basal Cell Carcinoma↗
PubMedDate not supplied

Follicular lymphoid hyperplasia of the hard palate simulating lymphoma.

Follicular lymphoid hyperplasia of the hard palate is a slowly growing, soft, nontender swelling that may grow to involve the entire hard palate. The overlying mucosa is normal. This appearance naturally prompts biopsy, and both clinically and microscopically might be confused with lymphoma. Four case histories are presented with histologic description: normal palatal submucosal structures are replaced with benign reactive lymphoid tissue replete with well-developed germinal centers. Surrounding these centers are dense populations of small, regular, bland lymphocytes. Minor salivary glands, except for some atrophied residue, are notably absent; also absent are the epimyoepithelial islands characteristic of the benign lymphoepithelial lesion (Mikulicz's disease). Etiologic factors remain obscure. One of our patients had two recurrences following local excision; in another patient nodules of benign lymphoid hyperplasia developed in the cheek and upper neck. These four patients are alive and free of any malignant process 4, 7, 9, and 12 years after the onset of their palatal swellings. We urge caution in distinguishing these lesions from palatal lymphoma, and recommend local excision as the treatment of choice.

Aged↗
PubMed1989

Metastatic anaplastic oligodendroglioma.

We report 7 patients, ages 21 to 49 years, with systemic metastasis from anaplastic oligodendroglioma. Metastases developed in the scalp, cervical lymph nodes, bone, and other organs 1 to 76 months after the most recent surgery and 18 to 86 months after diagnosis. Systemic metastases responded to focal radiotherapy or nitrosourea-based chemotherapy for 6 to 18 months. Five patients have died, 4 to 24 months after the appearance of systemic metastases, all with progressive cerebral and systemic tumor. We observed 2 distinct patterns of spread of oligodendroglioma. Pattern 1, initial scalp or regional lymph node involvement followed by distant metastasis, was associated with multiple craniotomies. Pattern 2, distant metastasis without scalp or regional lymph node spread, was associated with early radiotherapy and chemotherapy. Longer-than-expected survival was not essential to metastasis. We speculate that anaplastic oligodendrogliomas possess special characteristics favoring metastasis and that early aggressive treatment alters the biology of this disease.

Adult↗
PubMed1986

Soft tissue tumor with prominent leptomeric fibrils and complexes.

A recurrent soft tissue tumor from the groin in a 37-year-old male is described. The tumor cells contain many leptomeric structures, both fibrils and complexes, but none of the other characteristic features of striated muscle: alternating parallel thick and thin myofilaments with Z-line material. A review of one rhabdomyoma and six rhabdomyosarcomas demonstrates that leptomeric structures are present in large amounts in the rhabdomyoma but are very infrequent in only three of the six rhabdomyosarcomas. A careful search for leptomeric structures is indicated when the ultrastructural diagnosis of either rhabdomyoma or rhabdomyosarcoma is being considered.

Adult↗
PubMed1999

Imaging of a metastatic gastrointestinal carcinoid by F-18-DOPA positron emission tomography.

The localization of carcinoids in the gastrointestinal tract is frequently difficult if not impossible with the imaging procedures used to date. It is reported on a patient with metastasizing carcinoid in whom various imaging procedures were not successful in detecting the primary tumor. Due to the importance of primary tumor proof for potential curative surgical therapy, a whole-body positron emission tomography with F-18-DOPA was performed. PET enabled localization of a potential primary tumor in the ileum. Moreover, in addition to the known abdominal lymph node and liver metastases, it detected a mediastinal lymph node metastasis and a pulmonary metastasis. F-18-DOPA whole-body PET may be a very promising imaging approach to the localization and staging of gastrointestinal carcinoids.

Carcinoid Tumor↗
PubMed1992

Passive tumor targeting of soluble macromolecules and drug conjugates.

The biodistribution of soluble macromolecules is governed extensively by their ability to penetrate endothelial layers. Many solid tumors possess vasculature that is hyperpermeable to macromolecules, not always correlating with the presence of interendothelial cell fenestrations. The exact physiological mechanisms responsible for this nonspecific leakiness are not yet fully understood. Together with enhanced vascular permeability, however, tumors usually lack effective lymphatic drainage; consequently, they selectively accumulate circulating macromolecules (up to 10% of an i.v. dose per gram in mice). This "enhanced permeability and retention effect" (EPR effect) has been studied extensively, and it is thought to constitute the mechanism of action of SMANCS (styrene-maleic/anhydride-neocarzinostatin), now in regular clinical use in Japan for the treatment of hepatoma. It seems likely that EPR also contributes to the anticancer activity of the N-(2-hydroxypropyl)methacrylamide copolymer-anthracycline conjugates which are shortly to undergo clinical evaluation in the U.K.

Antineoplastic Agents↗
PubMedDate not supplied

Blue nevus of the lymph node capsule. Report of a case.

A case of blue nevus in the lymph node capsule is described. It's not a common pathology and only few cases have been reported so far. Nevus-cell aggregates in the same location are more frequent and difference between the two entities is described. So for histogenesis of these lesions, a melanocyte migration arrest is favoured rather than the hypothesis of a 'benign metastasis' from a cutaneous primitive site.

Axilla↗
PubMedDate not supplied

Lymphatic drainage and CTV in pancreatic carcinoma.

CTV definition in exclusive or adjuvant radiation therapy of pancreatic carcinoma is essentially based on the opinion of "expert" authors and on the knowledge of lymphatic pathways. The subject has been widely debated. Radiotherapy treatments of the entire upper abdomen (liver and pancreatic region), pancreas and lymph node stations, to volumes focused on macroscopic tumor only, have been proposed. Carcinoma of exocrine pancreas is characterized by the frequent, early appearance of metastasis via the lymphatic route. Most commonly involved lymph node stations include those of the celiac trunk, superior mesenteric, peripancreatic, lumboaortic lymph nodes, those of the hepatic portal (the latter in particular for pancreatic head tumors) and of the hilum of spleen (the latter in particular for pancreatic tail tumors). The possible multicentricity of pancreatic carcinoma, most likely due to intraductal spread, should lead to the inclusion in the CTV of the entire pancreatic parenchyma. This should be considered also for the frequent perineural intra- or extrapancreatic spread of pancreatic carcinoma present also in small tumors (T1). In extrapancreatic spread the retropancreatic adipose tissue should be included in the CTV at least at the GTV level. At the present state of knowledge, in the absence of pattern of failure analysis and of comparison of different treatment approaches, in terms of the definition of volumes of interest, CTV definitions which include lymphatic drainage stations, most part of pancreatic parenchyma and retropancreatic adipose tissue seem justified especially in treatments for cure. In palliation, the CTV may be limited to the GTV and the adipose tissue behind it.

Adipose Tissue↗
PubMed1990

Chromogranin A, neuron-specific enolase and synaptophysin as neuroendocrine cell markers in the diagnosis of tumours of the gastro-entero-pancreatic system.

Neuroendocrine (NE) tumours of the gastro-entero-pancreatic tract were analysed immunohistochemically for the expression of chromogranin A, neuron-specific enolase and synaptophysin. In all cases at least one marker was present and in 17 out of 19 investigated neoplasms, at least one of the three markers could be demonstrated in more than 75% of the NE tumour cells. Monoclonal antibody chromogranin A stained a much higher proportion of NE cells in tumours with hormonal activity than in hormonally inactive ones. Immunostaining of the primary tumour as compared to its respective metastases was almost identical. Thus, chromogranin A, neuron-specific enolase and synaptophysin identify NE tumours and their metastases regardless of their localization and their state of hormonal activity. As 'panendocrine' markers of NE tumours they are of special diagnostic value in NE tumours that do not produce hormones and peptides.

Adult↗
PubMed1990

Chordoma in a cat.

A chordoma within the deep musculature adjacent to C3 and C4 was excised from a 14-year-old castrated domestic cat. Metastatic chordoma developed in a prescapular lymph node 10 months later. At necropsy 11 months after complete excision of the primary tumor, metastases were found in both retropharyngeal lymph nodes.

Animals↗